Exercise based cardiac rehabilitation has been shown to significantly reduce morbidity and mortality in cardiac patients including those patients suffering from heart failure. Exercise based cardiac rehabilitation is not always offered within a hospital setting due to various constraints. These constraints include, but are not limited to, limited availability of such programs, feasibility for the patient to participate, availability of secondary resources, etc.
Of those cardiac rehabilitation programs that do exist, exercise is generally prescribed from generic heart rate guidelines. Such is the case as many available cardiac rehabilitation programs are not operated in a hospital setting. In cases where physicians attempt to adjust generic heart rate guidelines to suit individual patients, the adjustments performed are also largely informed by generic guidelines. Any thresholds that are calculated, however, are subject to changes in the health of the patient.
Home-based cardiac rehabilitation programs have been shown to be a potential alternative for cardiac patients. Home-based cardiac rehabilitation programs provide benefits at reduced cost compared to more formal cardiac rehabilitation programs. Still, home-based cardiac rehabilitation programs provide little to no monitoring of risk factors and heart function in the patient. This lack of oversight is a significant source of concern for patient safety.
To illustrate the potential risk posed by lack of oversight, up to approximately a third of cardiac patients were found to have experienced an adverse event within a hospital setting during supervised cardiac rehabilitation. In more than half of these cases, changes to the treatments of the patients were required as a consequence of the event in order to ensure patient safety and reduce overall risk to the patients.